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Normal and abnormal foveal development

Mervyn G Thomas1, Eleni Papageorgiou2, Helen J Kuht3

  • 1Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK mt350@le.ac.uk ig15@le.ac.uk.

The British Journal of Ophthalmology
|November 5, 2020
PubMed

Insights

Foveal development involves inner retinal layer displacement and outer retinal changes after birth. Assessing foveal hypoplasia (FH) using optical coherence tomography aids diagnosis and predicts visual acuity, especially in children.

Area of Science:

  • Ophthalmology
  • Developmental Biology
  • Genetics

Background:

  • Normal foveal development begins in utero with inner retinal layer displacement.
  • Outer retinal changes, including cone cell body increase and elongation, occur postnatally until age 13.
  • Optical coherence tomography (OCT) assesses foveal maturity, revealing a pit, extruded inner retinal layers, thickened outer nuclear layer, and elongated outer segments.

Purpose of the Study:

  • To describe normal and abnormal foveal development.
  • To highlight the role of optical coherence tomography in assessing foveal maturity and abnormalities.
  • To establish the correlation between foveal hypoplasia grading and visual acuity.

Main Methods:

  • Review of normal foveal development stages.
  • Analysis of optical coherence tomography findings in various foveal hypoplasia conditions.
  • Correlation of foveal hypoplasia morphology and outer segment thickness with visual acuity.

Main Results:

  • Foveal hypoplasia (FH) results from developmental abnormalities and is associated with conditions like albinism, aniridia, and achromatopsia.
  • Outer retinal layer disruption and abnormal inner retinal layer lamination are observed in conditions like achromatopsia and retinal dystrophies.
  • Outer segment thickness serves as a surrogate marker for cone density, strongly correlating with visual acuity in FH.

Conclusions:

  • Foveal hypoplasia morphology provides diagnostic clues, and its grading correlates with visual acuity.
  • Outer segment thickness is a key indicator of cone density and visual prognosis in foveal hypoplasia.
  • Grading foveal hypoplasia in preverbal children can help predict future visual acuity.

Keywords:
Embryology and developmentGeneticsImagingMaculaRetina

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